BACKGROUND: Artificial intelligence (AI)-based tools have shown promise in histopathology image analysis in improving the accuracy of oral squamous cell carcinoma (OSCC) detection with intent to reduce human error.
OBJECTIVE: This systematic review and meta-analysis evaluated deep learning (DL) models for OSCC detection on histopathology images by assessing common diagnostic performance evaluation metrics for AI-based medical image analysis studies.
METHODS: Diagnostic accuracy studies that used DL models for the analysis of histopathological images of OSCC compared to the reference standard were analyzed. Six databases (PubMed, Google Scholar, Scopus, Embase, ArXiv, and IEEE) were screened for publications without any time limitation. The QUADAS-2 tool was utilized to assess quality. The meta-analyses included only studies that reported true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN) in their test sets.
RESULTS: Of 1267 screened studies, 17 studies met the final inclusion criteria. DL methods such as image classification (n = 11) and segmentation (n = 3) were used, and some studies used combined methods (n = 3). On QUADAS-2 assessment, only three studies had a low risk of bias across all applicability domains. For segmentation studies, 0.97 was reported for accuracy, 0.97 for sensitivity, 0.98 for specificity, and 0.92 for Dice. For classification studies, accuracy was reported as 0.99, sensitivity 0.99, specificity 1.0, Dice 0.95, F1 score 0.98, and AUC 0.99. Meta-analysis showed pooled estimates of 0.98 sensitivity and 0.93 specificity.
CONCLUSIONS: Application of AI-based classification and segmentation methods on image analysis represents a fundamental shift in digital pathology. DL approaches demonstrated significantly high accuracy for OSCC detection on histopathology, comparable to that of human experts in some studies. Although AI-based models cannot replace a well-trained pathologist, they can assist through improving the objectivity and repeatability of the diagnosis while reducing variability and human error as a consequence of pathologist burnout.

UNASSIGNED: Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania and has a high prevalence and impact on global health. Currently, the available drugs for its treatment have drawbacks, such as high toxicity, resistance of the parasite, and high cost. Therefore, the search for new, more effective, and safe drugs is a priority. The effectiveness of an anti-leishmanial drug is analyzed through in vitro studies in which a technician manually counts the intracellular form of the parasite (amastigote) within macrophages, which is slow, laborious, and prone to errors.
UNASSIGNED: To develop a computational system that facilitates the detection and counting of amastigotes in microscopy images obtained from in vitro studies using image processing techniques.
UNASSIGNED: Segmentation of objects in the microscope image that might be Leishmania amastigotes was performed using the multilevel Otsu method on the saturation component of the hue, saturation, and intensity color model. In addition, morphological operations and the watershed transform combined with the weighted external distance transform were used to separate clustered objects. Then positive (amastigote) objects were detected (and consequently counted) using a classifier algorithm, the selection of which as well as the definition of the features to be used were also part of this research. MATLAB was used for the development of the system.
UNASSIGNED: The results were evaluated in terms of sensitivity, precision, and the F-measure and suggested a favorable effectiveness of the proposed method.
UNASSIGNED: This system can help researchers by allowing large volumes of images of amastigotes to be counted using an automatic image analysis technique.

UNASSIGNED: Deformable image registration (DIR) plays an important part in many clinical tasks, and deep learning has made significant progress in DIR over the past few years.
UNASSIGNED: To propose a fast multiscale unsupervised deformable image registration (referred to as FMIRNet) method for monomodal image registration.
UNASSIGNED: We designed a multiscale fusion module to estimate the large displacement field by combining and refining the deformation fields of three scales. The spatial attention mechanism was employed in our fusion module to weight the displacement field pixel by pixel. Except mean square error (MSE), we additionally added structural similarity (ssim) measure during the training phase to enhance the structural consistency between the deformed images and the fixed images.
UNASSIGNED: Our registration method was evaluated on EchoNet, CHAOS and SLIVER, and had indeed performance improvement in terms of SSIM, NCC and NMI scores. Furthermore, we integrated the FMIRNet into the segmentation network (FCN, UNet) to boost the segmentation task on a dataset with few manual annotations in our joint leaning frameworks. The experimental results indicated that the joint segmentation methods had performance improvement in terms of Dice, HD and ASSD scores.
UNASSIGNED: Our proposed FMIRNet is effective for large deformation estimation, and its registration capability is generalizable and robust in joint registration and segmentation frameworks to generate reliable labels for training segmentation tasks.

Stroke, the second leading cause of mortality globally, predominantly results from ischemic conditions. Immediate attention and diagnosis, related to the characterization of brain lesions, play a crucial role in patient prognosis. Standard stroke protocols include an initial evaluation from a non-contrast CT to discriminate between hemorrhage and ischemia. However, non-contrast CTs lack sensitivity in detecting subtle ischemic changes in this phase. Alternatively, diffusion-weighted MRI studies provide enhanced capabilities, yet are constrained by limited availability and higher costs. Hence, we idealize new approaches that integrate ADC stroke lesion findings into CT, to enhance the analysis and accelerate stroke patient management. This study details a public challenge where scientists applied top computational strategies to delineate stroke lesions on CT scans, utilizing paired ADC information. Also, it constitutes the first effort to build a paired dataset with NCCT and ADC studies of acute ischemic stroke patients. Submitted algorithms were validated with respect to the references of two expert radiologists. The best achieved Dice score was 0.2 over a test study with 36 patient studies. Despite all the teams employing specialized deep learning tools, results reveal limitations of computational approaches to support the segmentation of small lesions with heterogeneous density.

In medical clinical scenarios for reasons such as patient privacy, information protection and data migration, when domain adaptation is needed for real scenarios, the source-domain data is often inaccessible and only the pre-trained source model on the source-domain is available. Existing solutions for this type of problem tend to forget the rich task experience previously learned on the source domain after adapting, which means that the model simply overfits the target-domain data when adapting and does not learn robust features that facilitate real task decisions. We address this problem by exploring the particular application of source-free domain adaptation in medical image segmentation and propose a two-stage additive source-free adaptation framework. We generalize the domain-invariant features by constraining the core pathological structure and semantic consistency between different perspectives. And we reduce the segmentation generated by locating and filtering elements that may have errors through Monte-Carlo uncertainty estimation. We conduct comparison experiments with some other methods on a cross-device polyp segmentation and a cross-modal brain tumor segmentation dataset, the results in both the target and source domains verify that the proposed method can effectively solve the domain offset problem and the model retains its dominance on the source domain after learning new knowledge of the target domain.This work provides valuable exploration for achieving additive learning on the target and source domains in the absence of source data and offers new ideas and methods for adaptation research in the field of medical image segmentation.

UNASSIGNED: Lung image segmentation plays an important role in computer-aid pulmonary disease diagnosis and treatment.
UNASSIGNED: This paper explores the lung CT image segmentation method by generative adversarial networks. We employ a variety of generative adversarial networks and used their capability of image translation to perform image segmentation. The generative adversarial network is employed to translate the original lung image into the segmented image.
UNASSIGNED: The generative adversarial networks-based segmentation method is tested on real lung image data set. Experimental results show that the proposed method outperforms the state-of-the-art method.
UNASSIGNED: The generative adversarial networks-based method is effective for lung image segmentation.

OBJECTIVE: Vision Transformers recently achieved a competitive performance compared with CNNs due to their excellent capability of learning global representation. However, there are two major challenges when applying them to 3D image segmentation: i) Because of the large size of 3D medical images, comprehensive global information is hard to capture due to the enormous computational costs. ii) Insufficient local inductive bias in Transformers affects the ability to segment detailed features such as ambiguous and subtly defined boundaries. Hence, to apply the Vision Transformer mechanism in the medical image segmentation field, the above challenges need to be overcome adequately.
METHODS: We propose a hybrid paradigm, called Variable-Shape Mixed Transformer (VSmTrans), that integrates self-attention and convolution and can enjoy the benefits of free learning of both complex relationships from the self-attention mechanism and the local prior knowledge from convolution. Specifically, we designed a Variable-Shape self-attention mechanism, which can rapidly expand the receptive field without extra computing cost and achieve a good trade-off between global awareness and local details. In addition, the parallel convolution paradigm introduces strong local inductive bias to facilitate the ability to excavate details. Meanwhile, a pair of learnable parameters can automatically adjust the importance of the above two paradigms. Extensive experiments were conducted on two public medical image datasets with different modalities: the AMOS CT dataset and the BraTS2021 MRI dataset.
RESULTS: Our method achieves the best average Dice scores of 88.3 % and 89.7 % on these datasets, which are superior to the previous state-of-the-art Swin Transformer-based and CNN-based architectures. A series of ablation experiments were also conducted to verify the efficiency of the proposed hybrid mechanism and the components and explore the effectiveness of those key parameters in VSmTrans.
CONCLUSIONS: The proposed hybrid Transformer-based backbone network for 3D medical image segmentation can tightly integrate self-attention and convolution to exploit the advantages of these two paradigms. The experimental results demonstrate our method\'s superiority compared to other state-of-the-art methods. The hybrid paradigm seems to be most appropriate to the medical image segmentation field. The ablation experiments also demonstrate that the proposed hybrid mechanism can effectively balance large receptive fields with local inductive biases, resulting in highly accurate segmentation results, especially in capturing details. Our code is available at https://github.com/qingze-bai/VSmTrans.

This study aimed to develop a deep-learning (DL) based method for three-dimensional (3D) segmentation of the upper urinary tract (UUT), including ureter and renal pelvis, on non-enhanced computed tomography (NECT) scans. A total of 150 NECT scans with normal appearance of the left UUT were chosen for this study. The dataset was divided into training (n = 130) and validation sets (n = 20). The test set contained 29 randomly chosen cases with computed tomography urography (CTU) and NECT scans, all with normal appearance of the left UUT. An experienced radiologist marked out the left renal pelvis and ureter on each scan. Two types of frameworks (entire and sectional) with three types of DL models (basic UNet, UNet3 + and ViT-UNet) were developed, and evaluated. The sectional framework with basic UNet model achieved the highest mean precision (85.5%) and mean recall (71.9%) on the test set compared to all other tested methods. Compared with CTU scans, this method had higher axial UUT recall than CTU (82.5% vs 69.1%, P < 0.01). This method achieved similar or better visualization of UUT than CTU in many cases, however, in some cases, it exhibited a non-ignorable false-positive rate. The proposed DL method demonstrates promising potential in automated 3D UUT segmentation on NECT scans. The proposed DL models could remarkably improve the efficiency of UUT reconstruction, and have the potential to save many patients from invasive examinations such as CTU. DL models could also serve as a valuable complement to CTU.

Cracks are a common problem in concrete surfaces. With the continuous optimization of machine vision-based inspection systems, effective crack detection and recognition is the core of the entire system. In this study, support vector machine (SVM) was used to distinguish cracks from other regions. To complete the recognition system of the SVM, a framework consisting of an image processing and recognition model was proposed. An algorithm combining the Prewitt operator with the Otsu threshold was proposed for image segmentation. The binary image processed by the new algorithm combined with mathematical morphology can result in a more complete crack zone and fewer interference regions. After the initial parameter extraction, most of the impurity areas were screened by preliminary discrimination, removing 99% of the impurities. This processing step ensured the balance and effectiveness of the samples. To establish an automatic identification model based on SVM with a radial basis function, compactness, occupancy rate, and length-width ratio were selected as input parameters after comparing these three features with all six features of the crack. The recognition accuracy of this system reaches 97.14%, demonstrating that the proposed method is effective and satisfies practical requirements.

The morphological characteristics of the foot arch and the plantar soft tissue thickness are pivotal in assessing foot health, which is associated with various foot and ankle pathologies. By applying deep learning image segmentation techniques to lateral weight-bearing X-ray images, this study investigates the correlation between foot arch morphology (FAM) and plantar soft tissue thickness (PSTT), examining influences of age and sex. Specifically, we use the DeepLab V3+ network model to accurately delineate the boundaries of the first metatarsal, talus, calcaneus, navicular bones, and overall foot, enabling rapid and automated measurements of FAM and PSTT. A retrospective dataset containing 1497 X-ray images is analyzed to explore associations between FAM, PSTT, and various demographic factors. Our findings contribute novel insights into foot morphology, offering robust tools for clinical assessments and interventions. The enhanced detection and diagnostic capabilities provided by precise data support facilitate population-based studies and the leveraging of big data in clinical settings.